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Videoconferencing was widely used in court proceedings during the covid 19 pandemic, and, probably, its use will not return to the point before the pandemic. The academic literature indicates many different concerns with videoconferencing in court proceedings that may ultimately impact the legitimacy of the judicial process. This study aims to appreciate if academic research has been incorporated into the practical recommendations which guide daily work in courts. First, we conducted a literature review to identify and organise the concerns about using videoconferencing in court proceedings. Then we selected two guidelines and evaluated whether their recommendations addressed solutions to concerns raised in the academic literature. We conclude that most of the concerns are present in the guidelines. Although, the concern regarding the difficulty of replicating the environment of the physical courtroom in videoconferencing, which is the most cited concern, is not addressed in the practical guidance. © 2022 Associacao Portuguesa de Sistemas de Informacao. All rights reserved.
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Objective: to know the specific procedures and care provided to pregnant women, puerperal women and newborns in times of a pandemic and to analyze changes in prenatal care, labor, delivery and the postpartum period during the coronavirus pandemic. Methods: this is a qualitative, descriptive and exploratory study involving 26 women. The interviews were conducted via the Google Forms platform, with closed and open questions. Results: Two categories emerged from the study: 1) Influence of social isolation on the emergence of mental disorders;2) Adaptations with loss of sexual and reproductive, social and labor rights. Conclusion: mental health and sexual and reproductive, social and labor rights were shown to be more vulnerable in women who experienced pregnancy and postpartum in the coronavirus pandemic.
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Introduction: Depression is one of the most frequent mental health problems in older populations.1 To the best of our knowledge, the prevalence of depressive symptomatology (DS) among centenarians in Switzerland is unknown. Furthermore, the COVID-19 pandemic may have had a negative impact. As part of the study SWISS1002, we intend to provide key information on centenarians' levels of DS. Objective(s): To describe the DS of Switzerland's centenarians during the COVID-19 pandemic. Method(s): Randomly selected centenarians from across Switzerland and their proxy relatives were invited to participate. Data are collected via telephone. The questionnaire includes the assessment of DS via the Geriatric Depression Scale (GDS)- 5 items.3 Preliminary data were analysed using descriptive statistics. Result(s): Telephone interviews were completed with 51 centenarians, and for 19 of them, proxy relatives also answered. The MAge of the centenarians was 101.41 (1.47) years, 34 (66.67%) were female and 27 (52.94%) lived at home. The mean score of the GDS-5 was 1.32 (SD=1.49). Considering a cut-off >=2, 18 (36%) centenarians were screened positive for possible depression. Descriptive statistics indicated effects of gender (men: M=1.41, SD=1.46;women: M=1.27, SD=1.53) and living situation (private: M=1.07, SD=1.36;institution: M=1.61, SD=1.62). Centenarians' and proxy reports were significantly related (rho=0.56;p<.05). Conclusion(s): Clinically relevant DS are highly prevalent among centenarians during the COVID-19 pandemic (36%), which is consistent with a recent study4 reporting a prevalence of 32% in a sample of younger older adults (MAge: 77.6, SD=6.9). To conclude, DS in centenarians should be screened systematically, especially in this time of unprecedented health crisis.
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Introduction: Changes in sleep patterns have been documented worldwide since the onset of the Covid-19 pandemic. Among people infected by the new coronavirus, sleep disturbances were detected even after the acute phase of the disease, becoming a prevalent problem in Post-Covid Syndrome. Objective: The present study evaluated the quality of sleep (QS) and prevalence of insomnia among Covid-19 survivors undergoing a physical rehabilitation program. Methods: This is a descriptive, observational and cross-sectional study using the Pittsburgh Sleep Quality Index (PSQI);Insomnia Severity Index (ISI);and the question “whether sleep was better before Covid-19”;approved by the research ethics committee. Results: Fortytwo patients were evaluated between May and August 2021, referred to the Post-Covid Rehabilitation section, aged 45.6±14.5 years, 23 women (55%), BMI of 29.8±5.5 kg/ m2, median Covid diagnosis time of 96 days (22-485) and 60% with mild functional limitation (grade II). Twenty-five patients were hospitalized (59%) for an average of 15 days (1-90), 12 in intensive care (2 to 30 days) and 20 in the ward (1 to 60 days). Overall, poor QS and sleep disturbance occurred for 34 patients (81%), with 19 (56%) reporting sleeping well before Covid-19. Only eight patients (19%) had good QS. Twenty-two patients had a positive insomnia score, at the lower limit (33%), moderate (17%) or severe (2%);of which nine said reported having good quality sleep before Covid. Prevalence of Insomnia was 25% among wards hospitalization and 33% of critical cases. QS was compromised among 95% of patients hospitalized in the ward and for 66% of those who were in intensive care. Fatigue was the most prevalent symptom among other sleep disruptors. Conclusion: QS was impaired for most patients, with insomnia for more than half, for which sleep also became poor after Covid-19. High prevalence of fatigue, obesity and repercussions of illness should be considered. In view of the negative impact and bidirectional relationship of impaired sleep and physical and mental recovery, a more accurate investigation of sleep, as well therapies for its interfering factors, should be incorporated into the rehabilitation program.
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Given the large number of COVID-19 cases around the world, a practical solution to decrease and relieve the queue of patients in the hospitals and in the health care systems is welcome. Fast and reliable diagnosis based on technological tools can support medical professionals to manage this bottleneck situation, such as the diagnostic based on image techniques, which allows non-intrusive procedures. In this paper, we propose a practical methodology using deep learning to detect and classify lungs affected by COVID-19 using Chest X-ray radiography. RetinaNet architecture is considered here. This architecture is an one-stage object detection using focal loss often applied with dense, small and imbalance objects. We consider a dataset with 2500 images for model training and 1000 images to validate the model. Besides, a set of 1000 images from two different datasets are applied to test the pipeline approach. The obtained results show a specificity score of 0.54, precision of 0.68, recall of 0.994, and mAP of 0.913. The high recall score explains that a patient with COVID-19 will be classified correctly. © 2021 IEEE.
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Objetivos: Correlacionar os valores de dados laboratoriais – D-Dímero do primeiro dia (DD -ng/dL), Tempo de Protrombina (TP –segundos), Proteína C Reativa (PCR - mg/dL) – de pacientes COVID-19 positivo, com o desfecho de internação (alta hospitalar ou óbito), a necessidade de internação em Unidade de Terapia Intensiva (UTI), a necessidade de ventilação mecânica invasiva (VMI), a ocorrência de Trombose Venosa Profunda (TVP), Tromboembolismo Pulmonar (TEP), Acidente Vascular Cerebral Isquêmico (AVCI), Infarto Agudo do Miocárdio (IAM), a idade dos pacientes, a presença ou não de comorbidades e o gênero. Material e método: Trata-se de um estudo retrospectivo transversal observacional de análise sequencial e sigilosa de prontuários médicos. Foram incluídos no estudo os pacientes com COVID-19 confirmados por RT-PCR e com nível de D-Dímero acima de 1000 ng/mL, no período de março de 2020 a março de 2021. Para a análise dos dados foram utilizados os testes estatísticos Shapiro-Wilk, Mann-Whitney, Kruskal-Wallis, Teste de Dunn e Correlação de Spearman. Resultados: Foram incluídos 1220 pacientes, destes 42.5% tinham ao menos uma comorbidade, 31.6% necessitaram de ventilação mecânica invasiva, 17.6% necessitaram de internação em UTI, 57.4% tiveram alta hospitalar e 42.6% evoluíram para óbito. Dentre os pacientes analisados 2.5% apresentaram TVP, 2.6% TEP, 1.7% AVCI, 0.8% IAM. Resultado dos valores significativos: o grupo com alta hospitalar obteve intervalo interquartil (IQ) de DD = 1236.95-2742.87;IQ de TP = 11.1-12.7;IQ de PCR = 6.475-21.95. O grupo que evoluiu para óbito obteve IQ de DD = 1295.95-5376.3;IQ de TP = 11.4-13.5;IQ de PCR=8.75-27.15. O grupo que evoluiu com TEP apresentou IQ de DD = 2139.1-7252.3, já o que não evoluiu com TEP apresentou IQ de DD=1243.97-3558.12. O grupo submetido à VMI apresentou IQ de TP = 11.5-13.3;IQ de PCR=13.375-29.75, já o que não foi submetido apresentou IQ de TP = 11.1-12.9;IQ de PCR = 6.5-22.2. O grupo que necessitou de internação em UTI apresentou IQ de TP = 11.5-13.42;IQ de PCR=9.3-27.8, o que não necessitou apresentou IQ de TP=11.17-13;IQ de PCR = 6.975-23.5. Os pacientes do gênero feminino apresentaram IQ de TP=11.1-12.8, IQ de PCR = 6.8-22.6;os do gênero masculino apresentaram IQ de TP = 11.4-13.1, IQ de PCR = 7.8-25.4. Discussão: Conforme os valores encontrados, os pacientes com idade avançada apresentaram valores de DD, TP maiores e evoluíram mais para óbito;os do gênero masculino apresentaram maior mortalidade, PCR e TP comparado com o gênero feminino;os com comorbidades apresentaram PCR maior e evoluíram mais para óbito;os que tiveram alta apresentaram menor DD, PCR e idade e maior TP;os que necessitaram de VMI tiveram maior TP, PCR e óbitos;os que necessitaram de internação em UTI apresentaram maior valor de TP, PCR e mais óbitos;os que necessitaram mais dias de internação apresentaram menor TP, PCR e mais óbitos;os que evoluíram com TEP apresentaram DD maior;os que evoluíram com AVCi apresentaram maior TP;os que evoluíram com TVP, IAM e AVCi não apresentaram significância estatística de DD. Conclusão: Neste estudo, valores de DD maiores estiveram relacionados à maior mortalidade e à ocorrência de TEP. Valores de TP elevados relacionaram-se a maior mortalidade, internação em UTI, necessidade de VMI e presença de AVCi. Valores de PCR elevados estiveram relacionados à maior mortalidade, presença de comorbidade, internação em UTI e necessidade de VMI. Demais correlações não apresentaram relevância estatística.
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Introduction: In late 2019, several cases of Coronavirus disease 2019 (COVID-19) were diagnosed in Wuhan, China, and then also diagnosed in other regions of the world, creating a global pandemic. Stroke is a heterogeneous syndrome comprising several pathophysiological mechanisms, many of which appear to be influenced by SARS-CoV-2 infection. This review article was developed to summarize information on the relationship between stroke and SARS-CoV-2 infection. Methodology:This is an integrative literature review. Data collection took place in December 2021 and January 2022 in the following databases: PubMed, Scielo and LILACS. To search for articles, the descriptors "COVID-19" were used;"cerebrovascular accident" and "cerebral ischemia", combined by Boolean operators. Results and discussion: Patients with COVID-19 who had stroke had more severe conditions, longer hospitalizations, higher mortality, but had comorbidities similar to patients who had stroke without the presence of SARS-COV-2 viral infection. Final considerations:With this study, it is possible to conclude that more articles are needed that faithfully seek the relationship between COVID-19 and CVA. To date, studies have shown a greater number of strokes related to severe cases of COVID-19, with higher mortality and longer hospital stays. Confounding factors need to be considered, such as age and more prevalent comorbidities in the populations studied.
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To be accepted as an alternative for farmers, new cultivars must have high productivity combined with characteristics of resistance to insects and diseases, which makes the selection process more difficult and complicated. This paper presents the results of a study conducted in 2020 in Londrina (Parana, Brazil) to evaluate the resistance/tolerance by submitting all genotypes to the same environmental conditions and subject to damage from the same number of bugs per cage, establishing different levels of E. heros infestation in soyabean plants, to subsequently evaluate their productivity indices and resistance/tolerance indicators. The present work aimed to test four levels of infestation in cultivars with the Block technology, and in promising lines developed by the Embrapa Soja breeding program for resistance/tolerance to E. heros, in addition to cultivar BRS 399 RR already on the market, as a standard for productivity and cycle. At the same time, the experiments were carried out to also test the hypothesis that tolerant and/or resistant genotypes abort a smaller number of pods and/or replace a large amount of fallen pods as a consequence of the damage caused by the insect. As part of the harvest was carried out in the days preceding the period of social isolation, as a result of COVID-19, the post-harvest analyzes planned for the laboratory are still being carried out on a rotating basis. Thus, there was not enough time to process the samples collected and the data obtained, as well as to carry out the predicted correlations and presentation of results.
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Introduction: Healthcare worker adherence to proper Hand Hygiene (HH) practices and access to alcohol-based hand-rub (ABHR) remains limited in many low-resource settings. An effective HH improvement strategy is a critical element of infection prevention and control (IPC) programmes, as seen in the ongoing COVID-19 pandemic. The project PASQUALE aimed to establish the WHO multimodal HH strategy at the University Hospital Bouaké, Côte d'Ivoire. Objectives: The project PASQUALE aimed to establish the WHO multimodal HH strategy at the University Hospital Bouaké, Côte d'Ivoire. Methods: The improvement of HH knowledge and HH compliance was assessed in a before-and-after intervention study. The intervention consisted of a HH training for staff of all departments regardless of their participation in the initial assessment and the introduction of local production of ABHR. Assessment of HH knowledge and compliance was performed 12 months before (06/2018), right after the intervention (10/2019) and at a ten months interval (08/2020), whereby knowledge was assessed through a self-administered questionnaire and HH compliance through direct observations. Results: Baseline knowledge score was 14/25, increased significantly to 17/25 upon the first and decreased to 13/25 in the second assessment. HH compliance showed a significant increase from 12.7% to 36.8% (p < 0.001) in first and remained at 36.4% in second follow-up. An average of 74.4L ABHR per month were produced from 07/2019 until 03/2020, when the first COVID-19 infection was confirmed in Côte d'Ivoire, and 138L per month from 04/2020 onwards. Monthly consumption of ABHR in the same time increased from 76 to 125L. Conclusion: The implementation of the WHO HH improvement strategy led to sustained improvements in HH compliance without relying on costly interventions. This study emphasized that the implementation of the strategy is feasible and has effectively contributed to the IPC response during the COVID-19 pandemic.
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Introduction: In response to the COVID-19 pandemic, the WHO launched a strategic preparedness and response plan, outlining public health measures to support countries worldwide. Objectives: Our study aimed to assess the level of preparedness of health care workers (HCWs) towards COVID-19 and strenghten HCWs knowledge and perception of the SARS-COV-2 pandemic and its related Infection prevention and control (IPC) measures in Faranah, Guinea. Methods: We conducted a cross-sectional pre- and post-intervention study between april 2020 and march 2021. This consisted of a baseline assessment, in-person training, an immediate post-training follow-up and a three months follow-up. Participants were HCWs from the Faranah Regional Hospital (HRF) and two health care centres (HCC). The assessment was carried-out using a questionnaire developed based on WHO recommendations. Data was analysed using STATA Version 17. Results: There was no significant difference in the overall mean knowledge score during baseline (32.67 ± 5.81) and second follow-up (33.96 ± 4.04 p < 0.467). Subgroup analysis found significant improvement in knowledge for the HCC, but not for the hospital, comparing baseline (29.35 ± 6.89) and second follow-up (34.38 ± 3.89, p < 0.007). Overall, there was significant improvement in knowledge among Auxiliary Nurses in the HCC (baseline 28.21 ± 6.68, follow-up 33.87 ± 4.26 p < 0.010), while no significant improvement was observed in other profession groups in both HRF and HCC. Assessment of perception towards Covid-19 pandemic revealed that 48.6% of participants responded feeling helpless regarding the pandemic at baseline, while only 12.9% responded this way after second follow-up. Conclusion: The study highlighted optimal level of preparedness towards COVID-19 and its IPC measures among HCWs in both HRF and HCC as reflected by the good knowledge score noted in both baseline and follow-ups. Knowledge was further strengthened in the HCC-relatively low resourced facilities as compared to HRF, as shown by improvement in knowledge after training. Furthermore, IPC training was a key component in improving certain perceptions HCW's had towards COVID-19.
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Introduction: The Multimodal WHO Hand Hygiene (HH) Strategy is a widely used and well recognized approach. However, the evidence on the sustainability in low-resource settings is still scarce. The WHO strategy was implemented at the Regional Hospital of Faranah (HRF), but context specific challenges developed. Objectives: We aimed to promote HH culture by addressing these challenges and implementing appropriate solutions. Methods: Over a period of 3 years, the project team used quantitative and qualitative methods to assess HH improvement. Local staff was trained and instructed to track the development, identify barriers and find solutions to build a sustained HH culture. Results: Four main barriers were identified and addressed by targeted measures. 1) The lack of staff for local production was overcome by implementing a train the trainer approach. The initially trained pharmacist trained four other team members. To further strengthen the production team, a national solution of training and sending staff is proposed by the HRF. 2) Difficulties in obtaining production ingredients in high quality were addressed by purchasing large quantities and the establishment of a storage room in the hospital pharmacy. 3) To prepare for sustainable local production, the return, recycling and exchange of empty bottles was planned by opening a register of distribution. 4) To stop the decrease in knowledge and compliance over time, a HH championship every 6 months was initiated. All hospital departments were invited to participate and staff assessed via the WHO knowledge questionnaires and HH observations. Furthermore, refresher trainings and demonstrations of HH were given in daily staff meetings. Conclusion: To build HH culture is feasible in low-resource hospitals such as the HRF. However, context specific challenges require locally designed solutions such as the introduction of recycling systems for ABHR bottles, organizing HH championships, or promoting daily staff trainings to maintain the improvement on HH practises and creating a HH culture. This development of a HH culture and its sustainable local production helped the HRF to respond to the current COVID-19 pandemic.
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To mitigate financial loss and follow the recommended sanitary measures due to the COVID-19 pandemic, self-reading, a method in which a consumer reads and reports his own energy consumption, has been presented as an efficient alternative for power companies. In such context, this work presents a solution for self-reading via chatbot in chatting applications. This solution is under development as part of a research and development (R&D) project. It is integrated with a method based on image processing that automatically reads the energy consumption and recognizes the identification code of a meter for validation purposes. Furthermore, all processes utilize cognitive services from the IBM Watson platform to recognize intentions in the dialog with the consumers. The dataset used to validate the proposed method for self-reading contains examples of analogical and digital meters used by Equatorial Energy group. Preliminary results presented accuracies of 77.20% and 84.30%, respectively, for the recognition of complete reading sequences and identification codes in digital meters and accuracies of 89% and 95.20% in the context of analogical meters. Considering both meter types, the method obtains an accuracy per digit of 97%. The proposed method was also evaluated with UFPR-AMR public dataset and achieves a result comparable to the state of the art. © 2021, Brazilian Society for Automatics--SBA.
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The increased emissions of reactive nitrogen gases from anthropogenic sources to the atmosphere has been pointed out as responsible for triggering a series of environmental problems at the local, regional, and global scale. Among the many consequences associated with the excess of reactive nitrogen in the environment is the increase of atmospheric aerosol formation. In this way, the present review article aims to provide an overview of the main aerosol formation reactions from the reactive nitrogen gases, their growth processes, and removal from the atmosphere. The paper also addresses the implications of increasing the atmospheric aerosol load, including effects on the planet's radiative forcing, cloud formation and precipitation, macronutrient dispersion, visibility and human health. The possible relationship between the long-term exposure to these pollutants and COVID-19 fatality is also discussed. The need for more information related to reactive nitrogen gases and atmospheric aerosols is urgent since they act on fundamental processes on planet Earth and their quantity and composition have been abruptly changed over the last hundred years. Therefore, further investigations on this topic should be stimulated and better integrated in order to guide normative decisions and the delineation of possible solutions. © 2021 Sociedade Brasileira de Quimica. All rights reserved.
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Background: Our Palliative Care Team (PCT) promotes integrated care between the hospital and home. Due to the COVID-19 pandemic, between the March 23 and May 2, the government declared a state of emergency. Aims: To analyse how the emergency period affected the performance of the team. Methods: Retrospective study comparing the delivery of care in hospital and at home during the emergency period and similar period in 2019. Statistical analysis used the SPSS programme, version 20. Results: In 2020, there were 96 attended patients (31 in-hospital and 65 domiciliary). In 2019, 100 patients were attended to (43 in-hospital and 57 domiciliary). Results comparing 2019 to 2010: In hospital, the average patient's age and the waiting time was similar (70.3 vs 70.6, P = .944;1.49 vs1.35 respectively, P = .73). Fewer women were attended (46.5% vs 25.8%, P = .057). The main causes for referral were pain and guidance of care (23% & 46.5% vs 12% & 67%). Most had oncological diseases (76.7% vs 83.9%, P = .32). Family conferences were similar (62.8% vs 64.5%, P = .53), although only 25% were face-to-face in 2020 (P = .001). There are more teleconsultations (0% vs 32%, P = .001) and psychological support (23% vs 51.6%, P = .012). The change in rate of hospital deaths was not significant (48.8% vs 61%, P = .205). In domiciliary care, patient's average age was similar (75 vs 74, P = .595) with no difference in gender (P = .289). The main disease remains oncological (63.2% vs 66.2%, P = .438). Teleconsultations increased (0% vs 27.7%, P = .003) and there was a reduction in face-to-face consultations (47.4% vs16.9%, P = .028). Mortality rate was similar (15.8% vs 18.5%, P = .812), but deaths at home decreased (66.7% vs 50%, P = .66). The psychological support was similar (15.8% vs 12.3%, P = .885). Conclusion: The way of delivering care was modified mainly by the use of electronic communication, but did not have implications in the type or the number of patients attended.
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Background: Due to the COVID-19 pandemic, between March 23 and May 2, the government declared a state of emergency. To adjust the response to the expected incremental demand, our Palliative Care Team (PCT) adopted various policies. The PCT works in a suburban acute care hospital with 360 beds. It is the primary hospital for around 180,000 people, and it is the secondary reference for 300,000 people. During this period, one of the main problems was the lack of health care professionals, as they were infected by the virus or because their primary focus was with COVID-19 patients. Another problem was the necessary use of personal protecting equipment and the need to avoid dissemination of the virus. Therefore, direct patient evaluation has decreased. Regarding the necessary deliver of palliative care the team has assessed and provided for the extra need of drugs and materials, provided electronic devices as an alternative method of communication, established protocols regarding prevalent symptoms, referenced a palliative care professional in the COVID wards, provided psychological support to all patients and families and provided 24-h palliative care consultation. Aims: The aim of this work is to analyse how hospital doctors evaluated the support of the PCT. Methods: Delivered an online survey to doctors working in the wards of the medical department, questioning: the PCT protocols and if they have used it, the 24-h support of the PCT and if they have used it and how they evaluate the PCT performance. Results: The survey was delivered to 80 doctors with 19 responses. Most doctors worked directly with COVID-19 patients. About 64.7% of respondents have acknowledged the protocols and 63.6% used it;81.8% considered the protocols useful. Concerning the 24-h support, 53.8% knew about it and 30.8% used it. About 84.6% considered the performance of the PCT greater than 7/10. Conclusion: During the emergency pandemic period, the policies adopted by the PCT seem successful.